What is AP spine L1-L4?
An example of a successful AP lumbar spine scan. L1-L4 indicates proper placement of vertebral lines between each vertebra (step 3.1.1). The purpose of this paper is to introduce a promising, novel method to aid in the assessment of bone quality in forensically relevant skeletal remains.
What is AP diameter of the spinal canal?
The mean AP diameter of the spinal canal is 12mm. Stenosis exists when there is less than 10mm diameter, or a cross sectional area of less than 100mm 2. A minimum cross sectional area of 77 +/- 13mm 2 is required to accomodate average sized neural elements. Men have narrower spinal canals at the L3-L5 levels hence a higher rate of stenosis.
What is AP and lateral?
The AP view is the opposite. What is a lateral view? of or relating to the side; situated at, proceeding from, or directed to a side: a lateral view. pertaining to or entailing a position, office, etc., that is different but equivalent or roughly equivalent in status, as distinguished from a promotion or demotion: a lateral move.
What is the primary curve of the spine?
What are primary and secondary spinal curves? Primary curves are the curves in the spine that we’re born with; namely the thoracic and sacral curves. These curves are formed in the developing fetus and are structural in nature. Secondary curves on the other hand are formed in response to muscle strengthening and develop a little bit later.
How to tell if a spinous process is rotating?
What is the curvature of the cervical spine?
Where should the spinous process be?
Why should the chin be raised?
What is the centering point of a central ray?
Where should the central ray be directed?
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About this website
What is AP and lateral views?
Posterior-Anterior (PA) films are performed while the patient faces away from the x-ray tube. The x-ray beam goes in their posterior and comes out their anterior. Lateral radiographs are ones in which the patient stands sideways to the x-ray tube.
What are the 3 types of spine?
The spine has three normal curves: cervical, thoracic and lumbar. There are seven cervical vertebrae in the neck, 12 thoracic vertebrae in the torso and five lumbar vertebrae in the lower back.
What is an AP view?
The AP view examines the lungs, bony thoracic cavity, mediastinum, and great vessels. This particular projection is often used frequently to aid diagnosis of acute and chronic conditions in intensive care units and wards.
What is C spine AP?
The cervical spine (sometimes abbreviated as c-spine in the medical world) begins at the base of the skull. Seven vertebrae make up the cervical spine with eight pairs of cervical nerves. The individual cervical vertebrae are abbreviated C1, C2, C3, C4, C5, C6, and C7.
What part of the spine controls the legs?
Lumbar regionLumbar region The lumbar spinal cord is the lower area of the back. Nerve roots coming from the spinal cord in the lumbar spine control the legs.
Which part of the spine is most vulnerable to injury?
The lower back of the body, also known as your lumbar spine, is the most prone to injury – especially a strain injury. Lower back pain is a common complaint following a car accident. The lower back is made up of bones, muscles, and tissues that connect all the way from the cervical spine down to your pelvic bone.
What is difference between AP and PA view?
The erect anteroposterior chest view is an alternative to the PA view when the patient is too unwell to tolerate standing or leaving the bed 1. The AP view examines the lungs, bony thoracic cavity, mediastinum, and great vessels.
What is AP pelvis?
The AP pelvis view is part of a pelvic series examining the iliac crest, sacrum, proximal femur, pubis, ischium and the great pelvic ring.
How is an AP view obtained?
For the AP view, the arm is slightly abducted, and the thorax can be rotated to place the posterior shoulder against the image receptor. The center of the image receptor is at the glenohumeral joint. The arm/hand can be in a neutral, internal, or external position affecting the projection of the humeral head.
Can cervical spondylosis affect the brain?
Cervical spondylosis may lead to white matter damage, gray matter volume loss, and functional adaptive changes in the sensorimotor cortex. The results reported in this work may be of value to better understand the effect of prolonged cervical spine compression in the brain.
What is an AP image medical?
AP, X-ray: An X-ray picture in which the beams pass from front-to-back (anteroposterior). As opposed to a PA (posteroanterior) film in which the rays pass through the body from back-to-front.
What is the best treatment for cervical spondylosis?
In most cases, the symptoms of cervical spondylosis can be relieved using a combination of: medication – such as non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen. exercise – such as swimming and walking. self care techniques – such as supporting your neck with a firm pillow at night.
What are the 5 areas of the spine?
The vertebrae are numbered and divided into regions: cervical, thoracic, lumbar, sacrum, and coccyx (Fig.
How many spines do we have?
The average person is born with 33 individual bones (the vertebrae) that interact and connect with each other through flexible joints called facets.
What are the parts of the spine called?
The spine itself has three main segments: the cervical spine, the thoracic spine, and the lumbar spine. The cervical is the upper part of the spine, made up of seven vertebrae (bones). The thoracic is the center portion of the spine, consisting of 12 vertebrae. The lower portion of the spine is called the lumbar spine.
How many spines are there in the human body?
The human spine is composed of 33 vertebrae that interlock with each other to form the spinal column.
Cervical spine (AP oblique view) | Radiology Reference Article ...
The AP oblique cervical spine projections are supplementary views to the standard AP, odontoid and lateral images in the cervical spine series and are always done bilaterally for comparison purposes. However, the PA oblique projection is preferred as it reduces radiation dose to the thyroid 1 compared to the AP oblique projection.
How many vertebrae are in the lumbar spine?
The lumbar spine anteroposterior or posteroanterior view images the lumbar spine in its anatomical position. The lumbar spine generally consists of five vertebrae (see: lumbosacral transitional vertebra ).
What is the advantage of PA position?
if performing erect, position the patient in the PA position; this has numerous advantages including reduced dose to the gonadal region and utilization of beam divergence; arms can be placed by the side, or the handlebars of the erect Bucky can be held for patient stability. The weight bearing PA view can be called the Ferguson technique.
Is the entire lumbar spine visible?
the entire lumbar spine should be visible, with demonstration of T11/T12 superiorly and the sacrum inferiorly.
How many vertebrae are in the thoracic spine?
The thoracic spine anteroposterior (AP) view images the thoracic spine, which consists of twelve vertebrae.
Should spinal imaging be taken erect?
ideally, spinal imaging should be taken erect in the setting of non-trauma to give a functional overview of the thoracic spine
What is the arrow on a lumbar spine X-ray?
2-10. A lateral lumbar spine X ray of the patient whose DXA study is shown in Fig. 2-11. The arrow indicates a region of endplate sclerosis and osteophyte formation.
What is the PA spine used for?
The PA lumbar spine has been, and continues to be, used extensively in densitometry for diagnosis, fracture prediction, and monitoring. Unfortunately, it is also the skeletal site most often affected by structural changes and artifacts that may limit its utility.
Why does the BMD of a fractured vertebra increase?
The BMD of a fractured vertebra will be increased because of the fracture itself. This increase in density could erroneously lead the physician to conclude that the bone strength is better and the risk for fracture, lower, than is the case.
Does osteophytes increase BMD?
Effect of Osteophyteson BMD. In 1982, Krolner et al. (16) observed that osteophytes caused a statistically significant increase in the BMD in the AP spinewhen compared to controls without osteophytes. More recently, Rand et al. (17) evaluated a population of 144 postmenopausal women, aged 40 to 84 years, with an average age of 63.3 years, for the presence of osteophytes, scoliosis, and aortic calcification. These women were generally healthy women referred for the evaluation of BMD because of suspected postmenopausal osteoporosis. Table 2-5 lists the percentages of these women
Is the BMD at L3 higher than L2?
Although the BMD at L3 is expected to be higher than either L2 or L4, it is disproportionately higher. The L2-4 BMD will be increased because of the effect of the fracture on the BMD at L3. In the DXA PA lumbar spine study shown in Fig. 2-7, the image does not as readily suggest a fracture. The BMD at L1 however is higher than ...
Does aortic calcification affect BMD?
Aortic calcification will also potentially affect the BMD when measured in the AP or PA spine because the X-ray beam will detect the calcium in the aorta as it passes through the body on an anterior to posterior or posterior to anterior path.
Vertebral Fractures
The BMD of a fractured vertebra will be increased because of the fracture itself. This increase in density could erroneously lead the physician to conclude that the bone strength is better and the risk for fracture, lower, than is the case. Vertebral fractures in osteoporosis frequently occur in the T7-T9 region and in the T12-L2 region (14,15).
Degenerative Changes and Dystrophic Calcification
Other structural changes within the spine can affect BMD measurements. Osteophytes and facet sclerosis can increase the BMD when measured in the AP or PA projection.
What Should I Do if I Feel Back Pain?
Back pain can come from disease in the discs, from trauma to the vertebrae, from arthritis in the many joints in the spine, from systemic conditions like osteoporosis, and others. Learn more from our Medical and Scientific Board here. Educate yourself about what you think might be causing your pain by reading the information at spinehealth.org, and see a specialized spine surgeon who can give you the best options to get you out of pain and back to your life.
What is the thoracic spine?
It creates a connection between the cervical spine and the lumbar spine. It also runs from the base of the neck to the abdomen, making it the only spinal region that attaches to the rib cage. Some of the thoracic spine’s most important roles include protecting the spinal cord and anchoring the ribs.
What is the cervical spine?
Cervical Spine Anatomy. The neck, also called the cervical spine, is a well-engineered structure of bones, nerves, muscles, ligaments, and tendons. The delicate structure of the cervical spine, which houses the spinal cord, is very strong and flexible. This allows the neck to move in all directions. The cervical spine has seven stacked bones called ...
How many bones are in the human spine?
The Human Spine Anatomy. The entire spinal column consists of 33 individual bones called vertebrae plus 2 sections of naturally fused vertebrae, the sacrum and the coccyx, located at the very bottom of the spine which are also an important part of your spine’s ability to function properly. When we talk about the spine, we often call it ...
How many vertebrae are in the lumbar spine?
The lumbar spine consists of five moveable vertebrae, numbered L1 through L5. The lumbar area is often affected by heavy lifting, sitting for too long, wearing improper shoes, and more. It is the most common part of the spine to cause disability that prevents people from going to work due to back pain.
What is the tailbone?
The Tail-bone, or Coccyx: This tiny bone comprised of 4-5 fused small vertebrae supports sitting and weight bearing. The primary functions of the spine include: Protecting the spinal cord, nerve roots, and internal organs. Providing the flexibility of motion. Providing structural support and balance for upright posture.
What are the functions of the spine?
The primary functions of the spine include: 1 Protecting the spinal cord, nerve roots, and internal organs 2 Providing the flexibility of motion 3 Providing structural support and balance for upright posture.
What is the L4?
Lumbar vertebrae are larger than the thoracic or cervical vertebrae, as they have to bear the weight of the spine and the head. The fourth lumbar spine vertebra (L4) is located towards the bottom ...
What is the L4 bone?
Like the other lumbar spinal bones, L4 primarily provides protection to the spinal cord. Also, it features a number of processes and grooves where muscles attach. This includes the spinous, transverse, and the inferior and superior articular processes.
What is the L4 disc?
Like the rest of the spinal vertebrae, L4 articulates, or connects, with other spinal vertebrae through circular cartilage, called annulus fibrosus discs. Last medically reviewed on January 20, 2018.
Which vertebrae are larger, cervical or lumbar?
Lumbar vertebrae are larger than the thoracic or cervical vertebrae, as they have to bear the weight of the spine and the head.
Why is it important to create a routine?
Creating a routine can help you be consistent with your exercises, medications, and better predict your bladder and bowel movements. Because everyone experiences spinal cord injury differently, a personalized approach to rehabilitation that targets your specific needs is essential.
What is the difference between incomplete spinal cord injury and partial spinal cord injury?
In contrast, individuals with incomplete spinal cord injuries (the spinal cord is only partly severed/damaged) will have partial control or sensation below the level of injury.
Why are neural pathways important for lumbar recovery?
Spared neural pathways play an essential role in the recovery of lumbar (and all other) spinal cord injuries because damaged neurons in the spinal cord are not capable of regeneration. Only spared neural pathways can utilize the spinal cord’s ability to adapt and rewire itself ( neuroplasticity) to relearn functions after a spinal cord injury.
What is lumbar spinal cord injury?
A lumbar spinal cord injury can cause varying degrees of paralysis in the lower body , also known as paraplegia. With an effective rehabilitation plan, people with paraplegia can maximize their functional abilities and lead fulfilling lives.
Why do people with spinal cord injuries lose motor control?
This occurs because no spared neural pathways exist (because the spinal cord has been completely severed due to the injury). In other words, there are no pathways to relay messages between the brain and areas below the level of injury .
How many segments are there in the lumbar region?
The lumbar region of the spinal cord consists of 5 segments (based on the five vertebrae found here). Each segment connects to, or innervates, a different area of skin for sensation and set of muscles for movement. The spinal cord itself ends around the L1-2 vertebrae level; however, nerve roots branch off the bottom of ...
What is the term for loss of control over the bowel and bladder muscles that can increase the risk of leaking,?
Neurogenic bowel and bladder: loss of control over the bowel and bladder muscles that can increase the risk of leaking, constipation, and urinary retention. Sexual dysfunction: impaired sexual functions due to the injury impeding the reflexes involved in sexual arousal.
How to tell if a spinous process is rotating?
Rotation can be detected by looking at the spinous processes in relation to the pedicles. The spinous process should be midline of the vertebral body, equidistant from both pedicles 3 . Any deviation from the midline indicates rotation is present. The spinous process will rotate toward the pedicle of the side farther from the image receptor 3.
What is the curvature of the cervical spine?
A lordotic curvature exists in the cervical spine. For this reason, a cephalic angle is required to project through the long axis of the vertebral column. This angle can and will vary between 5-20° depending on the position of the head.
Where should the spinous process be?
The spinous process should be midline of the vertebral body, equidistant from both pedicles 3 . Any deviation from the midline indicates rotation is present. The spinous process will rotate toward the pedicle of the side farther from the image receptor 3.
Why should the chin be raised?
chin should be raised to align the lower margin of the upper incisors to the mastoid tips/base of the skull (unless trauma when the patient is placed in a cervical collar)
What is the centering point of a central ray?
centering point. the central ray is midline centered at the level of C4 to enter immediately below the hyoid bone. 15° cephalad 2. collimation. laterally to include the entire cervical spine. superiorly to include C2 and inferiorly to include T2. orientation. portrait. detector size.
Where should the central ray be directed?
To achieve the best angle, the central ray should be directed at an angle that parallels the plane of the mandible and then directed to just below the hyoid bone. This allows for discrepancies in the tilt of the head (flexion/extension of the cervical spine).
Indications
- This projection is utilized in many imaging contexts including trauma, postoperatively, and for chronic conditions. Ideally, spinal imaging should be taken erect in the non-trauma setting to give a functional overview of the lumbar spine. Otherwise, patients with a suspected spinal injury must remain in the supine position without any movement.
Patient Position
- the patient is erect or supine, depending on clinical history
- in the supine projection, hands are placed by the patient's side
- if performing erect, position the patient in the PA position; this has numerous advantages including reduced dose to the gonadal region and utilization of beam divergence; arms can be placed by the...
Technical Factors
- anteroposterior projection
- suspended expiration (for a uniform density)
- centering point
- collimation
Image Technical Evaluation
- the entire lumbar spine should be visible, with demonstration of T11/T12 superiorly and the sacrum inferiorly.
- no patient rotation as evident by central spinous processes and the symmetrical appearance of the sacroiliac joints and iliac wings
- intervertebral jointsare visualized
- the entire lumbar spine should be visible, with demonstration of T11/T12 superiorly and the sacrum inferiorly.
- no patient rotation as evident by central spinous processes and the symmetrical appearance of the sacroiliac joints and iliac wings
- intervertebral jointsare visualized
- adequate image penetration and image contrast is evident by clear visualization of lumbar vertebral bodies, pedicles, and facet joints, with both trabecular and cortical bone demonstrated
Practical Points
- the three column concept of thoracolumbar spinal fracturesis of particular importance when assessing this image for pathology
- take particular care when imaging patient on a trauma trolley that the image receptor is aligned to the central ray to prevent anatomy exclusion and grid cut-off
- ideally, the transverse processes should be visible, although demonstration is often obscure…
- the three column concept of thoracolumbar spinal fracturesis of particular importance when assessing this image for pathology
- take particular care when imaging patient on a trauma trolley that the image receptor is aligned to the central ray to prevent anatomy exclusion and grid cut-off
- ideally, the transverse processes should be visible, although demonstration is often obscured by overlying bowel gas; radiographers should ensure over exposure is not a factor contributing to the p...
- when imaging in a supine position, a triangular cushion can be placed under flexed knees to reduce lumbar lordosis, and thus aiding to open the intervertebral joints
Indications
Patient Position
- the patient is erect or supine, depending on clinical history
- hands are placed by the patient's side
Technical Factors
- anteroposterior projection
- arrested inspiration (to push the diaphragm downwards over the upper lumbar vertebra)
- centering point
- collimation
Image Technical Evaluation
- The entire thoracic spine should be visible from T1 to T12: 1. no patient rotation as evident by central spinous processes with sternoclavicularjoints appearing equidistant 2. intervertebral jointsare seen in profile 3. adequate image penetration and image contrast is evident by clear visualization of thoracic vertebral bodies, with both trabecular and cortical bone demonstrated
Practical Points
- the three-column concept of thoracolumbar spinal fracturesis of particular importance when assessing this image for pathology
- take particular care when imaging patient on a trauma trolley that the image receptor is aligned to the central ray to prevent anatomy exclusion and grid cut-off
- flexing the patient's legs or providing a pillow under the knees may improve patient comfort, …
- the three-column concept of thoracolumbar spinal fracturesis of particular importance when assessing this image for pathology
- take particular care when imaging patient on a trauma trolley that the image receptor is aligned to the central ray to prevent anatomy exclusion and grid cut-off
- flexing the patient's legs or providing a pillow under the knees may improve patient comfort, whilst reducing spinal lordosis